Assessment of protein energy malnutrition in older persons, part I: History, examination, body composition, and screening tools

Protein-energy malnutrition is a prevalent problem in older persons. Its re lation to increased morbidity and mortality has been well documented. Early recognition of malnutrition allows for a timely intervention. A large prop ortion of chronic diseases affecting older persons can be either prevented or significantly improved by improving nutrition, which underscores the imp ortance of developing a screening system that can trigger a more comprehens ive evaluation when indicated. Screening for malnutrition in older persons can be difficult because of the normal age-related changes in many of the c ommonly used parameters. A comprehensive nutritional evaluation includes a complete history and physical examination in addition to a more specific nu trition-oriented assessment. Specific nutritional assessment includes estim ating food intake, anthropometric measurements, and evaluation of several b iochemical parameters commonly affected by changes in nutritional status. I n this article, we review the commonly used tools for nutritional assessmen t in older persons. The goal is to promote disease-free, active, and succes sful aging. (C) Elsevier Science Inc. 2000.